Mail to: Taxation Division Phone: (573) 522-4989 P.O. Box 295 Fax: (573) 522-1721 Jefferson City, MO 65105-0295 E-mail: nexus@dor.mo.gov Form 5741 (Revised 02-2019)

Make check payable to the address listed below. Do not send cash. You may not use your individual income tax refund to pay your use tax liability. Do not send with individual income tax return. If you pay by check, you authorize the Department of Revenue to process the check electronically. Any check returned unpaid may be presented again electronically.

DOR ONLY

Pay This Amount (U.S. Funds Only)

Amount of Tax City/County Code(s) Use Tax Rate

r One time purchase r I expect to make future taxable purchases.

Interest For Late Payment

Additions To Tax

City County Purchase Price

* If the Taxpayer has legally paid Sales Tax, Consumers Use Tax, or other similar tax to another state, then the taxpayer is entitled to a credit. The Taxpayer shall provide sufficient proof of such tax payment before a credit is allowed. A purchaser is required to file a use tax return if the cumulative purchases subject to use tax exceed $2,000 in a calendar year. Use tax is computed on the purchase price of the goods. For more information visit dor.mo.gov/personal/consumer.

Department Use Only(MM/DD/YY)

Pur

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onsu

mer

’s U

se T

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Missouri Tax Identification Number Federal Employer Identification Number Business Name (if applicable)

Last Name First Name M.I. SSN

Street Address City State ZIP Code

__ __ /__ __ /__ __ __ __

Co-

Ow

ner’

s

Missouri Tax Identification Number Federal Employer Identification Number Business Name (if applicable)

Last Name First Name M.I. SSN

Street Address City State ZIP Code

Form

5741Missouri Department of RevenueAircraft Consumer’s Use Tax Return

Air

craf

t Purchase Date Make Model Serial Number N Number

Street Address (where Aircraft is Hangered) City State ZIP Code Inside City Limits Yes No

Jurisdiction Code(s)

Approved Credit

Reporting Period(MM/YY)

Sig

natu

re

__ __ /__ __ /__ __ __ __ (__ __ __)__ __ __–__ __ __ __

Signature(s) Date (MM/DD/YYYY) Daytime Telephone

By signing I am authorizing the Department of Revenue to issue any potential refund(s). Under penalties of perjury, I declare that the above information and any attached supplement is true, complete and correct. I have direct control, supervision, or responsibility for filing this return and payment of the tax due.

Print Name Title

Tax ID Numbers

Missouri Tax ID Number – This is an eight digit number used by the Missouri Department of Revenue to identify your business. If you do not have a number please leave blank.

Federal Tax ID Number – This is a nine digit number issued by the Internal Revenue Service to identify your business. If you do not have a number please leave blank.

Social Security Number (SSN) – If you do not have a Missouri tax ID number or a Federal ID number please provide your SSN.

Purchasers Information

Please list your complete name, ID number, business name (if applicable) and complete physical address.

Co-Owner Information

If aircraft is co-owned with another individual or business, please provide complete name, ID number, business name (if applicable) and complete physical address. If no co-owner leave blank.

Aircraft

List all requested information, purchase date, Make, Model, Serial Number, N-Number, Address where aircraft is hangered, and if the aircraft is Inside City Limits (this will help determine tax rate).

Consumer’s Use Tax

List the City and County where aircraft is hangered

Jurisdiction code and City/County Code, these codes may be found at dor.mo.gov/business/sales/rates.

Purchase price of aircraft.

Use tax rate, enter the use tax rate of the location where the aircraft is hangered. Tax rate may be found at dor.mo.gov/business/sales/rates

One Time Purchase or I expect to make future taxable purchase – Please select one of the boxes. If you select “One time purchase” you will be issued a Missouri Tax ID number to process your return, but you will not be required to register with the Department. If you select “I expect tomakefuturepurchases”,youwillhaveongoingpurchasesandneedtofilloutaregistrationapplication(Form 2643) or complete your registration online by going to dor.mo.gov/registerbusiness/.

Approved Credit

If the taxpayer has legally paid Sales Tax, or other similar tax to another state, then the taxpayer is entitled to a credit. The taxpayer shall providesufficientproofofsuchtaxpaymentbeforeacreditisallowed.

Interest for Late Payment

The interest rate is subject to change each year. Refer to the Department website http://dor.mo.gov/calculators/interest/ to calculate the amount of interest due.

Additions toTax

If the return is late enter the amount of additions to tax. The rate is 5 percent per month of total tax due, not to exceed 25 percent. Refer to the Department’s website at dor.mo.gov/calculators/interest/ to calculate the amount of additions due.

Aircraft Consumer’s Use Tax Return Instructions

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